杨恩品教授诊治玫瑰糠疹临证经验

崔碟 何媛 杨肆琳 杨恩品

【摘 要】 杨恩品教授认为“血热”为玫瑰糠疹发病的内在基础，“内外合邪，肌腠失养”贯穿了疾病发生发展的始终，遵循“治病必求于本”的原则，提出治疗上应从血分入手辨证论治，风盛者配以疏风止痒;挟湿者配以健脾化湿;挟毒者当凉血解毒;挟瘀者当活血化瘀;血虚者当滋阴养血。庶血热清，气血畅，肌腠调，而病愈。

【关键词】 玫瑰糠疹;从血论治;临床经验

【中图分类号】R249.2/.7   【文献标志码】 A    【文章编号】1007-8517（2020）9-0084-02

Professor Yang En-pin's Clinical Experience of Treating Pityriasis Rosea

CUI Die1 HE Yuan1 YANG Silin1 YANG Enpin2△

1.Yunnan University of Traditional Chinese Medicine，Kunming 650500，China;2.Department of Dermatology，

First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine，Kunming 650021，China

Abstract：professor Yang believes that“blood heat”as the inner base of pityriasis rosea onset，“pathogenic combination，muscular striae lost to nourish”throughout the course of the occurrence and development of the disease， follow the principle of “treating disease from the root”，and propose the treatment should be syndrome differentiation and treatment variation start with blood phase.Wind excessiveness with dispelling wind for relieving itching;Dampness is accompanied by invigorating spleen for eliminating dampness; “toxin” is accompanied by cooling blood removing toxic materials;blood stasis is accompanied by promoting blood circulation for removing blood stasis;Those with blood asthenia should nourish Yin and blood.So clearing blood heat，activating and harmonizing Qi-blood，regulating muscular striae，and disease recovery.

Key words：Pityriasis Rosea;Treatment from Blood;Clinical Experience

玫瑰糠疹（ pityriasis rosea， PR）是一種急性炎症性红斑、丘疹、鳞屑性皮肤病。中医称之为“风热疮”，古医籍中“风痒”“血疳”“风癣”“母子疮”等，描述的症状与本病相似。本病表现为：初发时多在躯干部先出现玫瑰红色母斑，继则分批出现较多、形态相仿而较小的椭圆形子斑，皮损长轴与皮纹走行方向一致。皮损好发于躯干及四肢近端，常伴不同程度的瘙痒。多见于青少年，好发于春秋季[1]。病程有自限性，一般6～8周，少数患者病情迁延、反复发作。杨恩品教授从事皮肤科教学、科研、临床工作35载，认为本病以血热内蕴为本，风热外感为标，治疗需以血为本，标本兼治。现将其诊治PR的经验总结如下。

1 基本病机

1.1 血热为本，外感风热致病 《医宗金鉴》称本病为“血疳”“由热闭塞腠理而成，形如紫疥，痛痒时作，血燥多热。”血热，即血分热证，是发病的基础。在血分有热基础上，风热外袭，内外合邪，蕴阻肌肤而发。西医认为，本病的发生，病原微生物特别是病毒感染是主要诱发因素，与中医外感相吻合。……